In the case of childhood ear infections, resistant strains have been similarly implicated in the weak primary immune responses and high relapse rates associated with antibiotic treatment. [note 17] Other frequent com- plications include superinfection with yeast and other common fungi, as well as the food and environmental allergies that often accompany them.

Furthermore, numerous studies have shown that the supposedly causative organisms isolated from children with chronic ear infetions are simply the common pathogens of the tonsils and nasopharynx, such as the "pneumococcus," or Streptococcus pneumoniae, Group A ?-hemolytic Streptococcus, Hemophilus influenzae type B, and Staphylococcus aureus, all of which are regularly found in healthy throats as well. [note 18] In 25% of children with acute otitis, and in 80% of those with the most prevalent chronic serous variety, the middle-ear discharges and cultures are sterile and contain no organisms whatsoever. [notes 19, 20] Once these resident bacteria are destroyed, the result could have been foreseen by ordinary common sense: chronic serous otitis, or "glue ear," an important cause of chronic and even permanent deafness. Thus even more destructive than these antibacterial weapons themselves is the fanatical strategy of attacking and killing that makes such imagery seem attractive.

A further application of the same approach has been the develop-ment of the pneumatic otoscope, its tight seal permitting the detection of even minute amounts of fluid and thus facilitating both early diagnosis and more minute surveillance. Yet diagnosing more infection has only unleashed more of the same firepower, and thus more of the same results already described. Indeed, with tympanostomy the war against chronic otitis media has reached its final dead end, since it looks like an obvious mechanical solution to the problem, yet has itself recently been found to be a major cause of otosclerosis and permanent hearing loss, the same spectre used to browbeat reluctant parents into accepting it in the first place. [note 21] Still more ironic is the fact that it simply makes permanent and structural the natural perforation and drainage that the acutely infected ear heals so well by itself and with so few complications.

In any case, it makes little sense to search out and destroy the friendly bacteria that already live with us and police our bodies so effect-ively most of the time, or to imagine that making war on them could ever produce anything but more devastation, more war, and ultimately more resistant and less friendly bacteria.

Although I have previously written about vaccinations in some detail, relatively little of my experience with vaccine-related illness is of the kind that Harris Coulter and Barbara Fisher write about in A Shot in the Dark, [note 22] or what might be termed the specific effects of a particular vaccine. While these reactions are apt to be the most severe and also the most useful in learning how to prescribe the nosodes that correspond to them, most of the complications I have seen in my practice have been limited to subtler reactions that I would describe as non-specific in type. By that I mean that they resemble exacerbations of the pre-existing chronic state, looking more or less the same in a given individual, regard-less of which vaccine is given, and are benefited by the same group of remedies are used to treat chronic illness in the general population, vaccinated or not. Although such reactions are more difficult to recognize and verify, they are also much more common, and I suspect much more important as well.

"Two of four cases suffered relapses of their chronic state after a vaccine, one suffered identical relapses after two different vaccines, and all four first developed their complaint during their initial series. In none were their responses acute enough to be identified as symptoms of the vaccine. What was repeatable was simply the chronicity of the responses."

Thus two of the four cases I presented suffered prolonged, severe relapses of their chronic state after a vaccination, one patient suffered almost identical relapses after two different vaccines, and all four first developed their chief complaint during their initial three-dose vaccine series. In no case were their responses acute or obvious enough to be identified as a repeatable symptom of the vaccine. Indeed, all that was repeatable in all cases and with all the vaccines was simply the chronicity of the responses, the fact that they occurred more frequently, persisted for longer periods of time, and were less likely to resolve spontaneously.

It is just this congruence between the vaccine-related responses and the original illness that suggests how vaccines act nonspecifically on the immune system as a whole, and so implicates vaccination in the basic riddle of chronicity itself. As new biotechnology companies produce new genetically-engineered vaccines as fast as possible, the unrestricted war against identifiable acute diseases has already added to the pre-existing chronic disease burden a considerable array of DNA and RNA fragments looking for chromosomes to recombine with and certain to engender new diseases of which as yet we know nothing. In short, I am afraid that doctors, like politicians, are here to stay.

Richard Moskowitz was born in 1938, and educated at Harvard (B.A.) and New York University (M.D.). After medical school he did 3 years of graduate study in Philosophy at the University of Colorado in Boulder on a U. S.......more

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